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心房颤动:心力衰竭相关住院的主要原因;双重流行病。

Atrial fibrillation: a leading cause of heart failure-related hospitalizations; a dual epidemic.

作者信息

Ahmed Asrar, Ullah Waqas, Hussain Ishtiaq, Roomi Sohaib, Sattar Yasar, Ahmed Faizan, Saeed Rehan, Ashfaq Ammar

机构信息

Internal Medicine, Abington-Jefferson Health Abington, USA.

Gastroenterology, Cleveland Clinic Florida, USA.

出版信息

Am J Cardiovasc Dis. 2019 Oct 15;9(5):109-115. eCollection 2019.

Abstract

BACKGROUND

Atrial fibrillation (AF), and heart failure (HF) are a major cardiovascular epidemic over the last decade. The prevalence and rehospitalization of heart failure are on rising edge, and many factors are responsible for these re-exacerbations of heart failure. In this study, we sought to determine an association of a risk factor for frequent rehospitalization of heart failure at our institute. We aimed to find the re-admission rate, heart rate, and rhythm of heart failure exacerbation.

METHODS

We performed a single-center retrospective study at the Abington Hospital - Jefferson health and 418 patients having a history of heart failure, and AF were selected. The heart failure readmission rate (days), heart rate, and rhythm were analyzed.

RESULTS

The mean age of the included population was 82.8 years SD ± 9.2. About 53% had AF with a mean heart rate 90 SD ± 21 bpm, and 47% had normal sinus rhythm (NSR) with a mean heart rate of 78 ± 16 bpm on re-admission. This difference was statistically significant (p=0.02). The mean re-admission rate for atrial fibrillation was 27.49 days SD ± 18.97, compared to 32.68 SD ± 20.26 days for NSR, statistically significant (p=0.007) and the Pearson Chi-square was also significant P = 0.006.

CONCLUSION

There is a significantly increased rate of re-admission in heart failure patients with atrial fibrillation with a rapid ventricular rate. Efforts should be taken to keep the patient in NSR or controlled AF to minimize the rehospitalization rate, and this, in turn, reduces the financial burden on patients and institutes.

摘要

背景

心房颤动(AF)和心力衰竭(HF)是过去十年中主要的心血管流行病。心力衰竭的患病率和再住院率呈上升趋势,许多因素导致心力衰竭的这些再次恶化。在本研究中,我们试图确定我院心力衰竭频繁再住院的危险因素之间的关联。我们旨在找出再入院率、心率和心力衰竭加重时的心律。

方法

我们在阿宾顿医院 - 杰斐逊健康中心进行了一项单中心回顾性研究,选择了418例有心力衰竭病史且患有房颤的患者。分析了心力衰竭再入院率(天数)、心率和心律。

结果

纳入人群的平均年龄为82.8岁,标准差±9.2。约53%的患者患有房颤,再入院时平均心率为90次/分,标准差±21次/分,47%的患者为正常窦性心律(NSR),平均心率为78±16次/分。这种差异具有统计学意义(p = 0.02)。房颤的平均再入院率为27.49天,标准差±18.97,而NSR为32.68天,标准差±20.26天,具有统计学意义(p = 0.007),Pearson卡方检验也具有显著性(P = 0.006)。

结论

快速心室率房颤的心力衰竭患者再入院率显著增加。应努力使患者维持在NSR或控制房颤状态,以尽量降低再住院率,进而减轻患者和医疗机构的经济负担。

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